长期尼可地尔治疗对冠状动脉慢血流患者血管内皮功能和血清超敏C反应蛋白水平的影响

Effects of Long-term Nicorandil Administration on Endothelial Function and hsCRP in Patients with Coronary Slow Flow

目的:探讨长期尼可地尔治疗对冠状动脉慢血流(CSF)患者血管内皮功能和血清超敏C反应蛋白(hs-CRP)水平的影响。方法:选择冠状动脉造影正常但存在CSF患者66例,随机分为尼可地尔组和常规治疗组,常规治疗组(33例)予以阿司匹林、他汀类药物等常规治疗,尼可地尔组(33例)在常规治疗基础上加用尼可地尔5mg,3次/日,连续治疗6个月。另选取18例年龄和性别匹配的正常老年人为对照组。对照组及治疗前后患者利用彩色多普勒超声测定血管内皮功能指标及血清hs-CRP水平。结果:(1)治疗前,CSF患者hs-CRP与对照组比较明显升高(P<0.01),CSF患者的加压反应性充血前后内径变化百分率(FMD)与对照组比较明显降低(P<0.01)。(2)经过6个月尼可地尔治疗后,尼可地尔组hs-CRP较常规治疗组明显下降(P<0.01),FMD较常规治疗组明显升高(P<0.01)。结论:经过尼可地尔治疗减少炎症反应,可以有效改善CSF患者血管内皮功能。

Objective：To investigate the impact of long-term nicorandil on endothelial function and serum high-sensitivity C-reactive protein（hsCRP） in patients with coronary slow flow.Method：A total of 66 patients with coronary slow flow but normal coronary angiography were included in this study,all patients were divided into nicorandil group（15mg/d for 6months,n=33） and usual care group（usual care,n=33）.Eighteen age-and sex-matched normal healthy participants served as controls.All study participants underwent flowmediated vasodilatation（FMD） of the brachial artery just before treatment and 6 months following treatment,and hs-CRP were checked.Results：（1） compared with controls group,patients with coronary slow flow demonstrated significantly decreased FMD just before treatment（P0.01）,while hsCRP were significantly lower in control group than nicorandil group and usual care group（P0.01）.（2）Compared with the usual care group,the nicorandil group demonstrated significantly increased FMD（P0.01） and decreased hsCRP（P0.01） after 6 months treatment.Conclusion：Long-term nicorandil theapy is associated with reductions systemic inflammatory markers and gradual improvements in endothelial function.